3 weeks post breast augmentation and things just don't seem right. Can I have a second opinion? (Photo)

This is the 3rd time that I've posted and not much has changed. It seems like my areola just keeps getting smaller and is detaching from my skin more and more. I just went and saw my surgeon last Tuesday and she said everything is fine and normal to just put salt water on the wound and it will heal itself. Well I got a call today saying that she wants to do stitches (to close the wound I'm guessing?) but she said NOTHING about stitches my last visit... I just need a second opinion.

Open wound after breast augmentation

October 28th, 2015

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Sorry to hear about your frustration. With careful followup and wound care, these wounds will heal although it should be expected to take several weeks. At that time, once everything has healed and all swelling and inflammation has resolved, you can consider revising the scar at a much later day. Attempting to reclose this wound only 3 weeks out from surgery might work but you should understand that there is the risk of the wound reopening. Good luck and hang in there.

Wound care

October 28th, 2015

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Hello,

Thank you for your question and photos. Under close supervision with careful wound care and infection prevention, allowing this to heal fully and then considering scar revision later is likely a safer approach than trying to close it with sutures at this point.

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3 weeks post breast augmentation

October 27th, 2015

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Thank you for the question and the picture. I am sorry to hear of your post operative difficulties. Trying to close the would at this point will only lead to the would reopening and potentially other complications. While difficult to believe this will heal. It will need continued local wound care and will most likely take at least 4 to 6 weeks to close. Should the resulting scar be unacceptable it can then be revised, but only after it has closed on its' own. I hope this helps. Best wishes.

Do I need a revision

October 27th, 2015

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From the photos you included, it appears to me, that at this point the breast tissue is still too tight to be able to go back undermine the flap all the way around and re-suture it to the irregular areola that still there. My plan would be to allow the wound to heal and area of the breast tissue to stretch such that a revision, essentially redoing the circum- areolar mastopexy would be possible. Good luck.

Three weeks postoperative, periareolar wound healing issue

October 27th, 2015

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Suturing this wound together at this point will likely result in the wound opening up again and "falling apart". The wound appears clean, pink and granulating which is what we like to see open wounds do as surgeons. This will eventually heal over time (possible 3-6 weeks) with conservative wound healing measures (like wet to dry dressings, use of antibiotic ointment, etc). Once healed, you will have a wide scar that can be revised (excised and closed) electively.

Nipple wound

October 27th, 2015

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Thanks for your question. I'm assuming you had a breast lift as well with an incision around the areola? This can happen on rare occasion. Yes, I would imagine your surgeon wants to see you to remove the sloughing tissues and re-close the wound. I would follow his/her advice here. Best wishes.

Wound separation

October 26th, 2015

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I would not be in agreement with a plan to try to suture these open wounds. In general most surgeons would choose local wound care until healed before choosing an operation for this. I don't think a surgeon would be able to suture the edges together without undue tension, which would likely result in another wound separation.

If would healing has stalled, options would be a (temporary) skin graft, or removal of the implants to allow closure, with plan to replace them in 3 months.

Sorry to read about this complication. I would get a second in person opinion before agreeing to wound closure as described.

3 weeks after BA

October 26th, 2015

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It would be very unlikely that a surgeon could simply stitch together the parts of your wound that have separated. As long as your areolas are still alive you would need to let these wounds completely heal before a scar revision. Another option would be to remove the implants for now to reduce the tension on your skin and attempt to close the wounds.

These answers are for educational purposes and should not be relied upon as
a substitute for medical advice you may receive from your physician. If you
have a medical emergency, please call 911. These answers do not constitute
or initiate a patient/doctor relationship.